12/18/2023 0 Comments Miotic pupil drug related![]() The second neuron, which is the preganglionic neuron, exits the spinal cord, ascends through the thorax and synapses near the apex of the lung into the superior cervical ganglion. This synapse is located between the C8 and T2 vertebrae. 1,2 The first neuron begins in the hypothalamus and descends through the midbrain to synapse onto a specific area of the spinal cord, known as the ciliospinal center of Budge. The sympathetic pathway, mainly responsible for pupil mydriasis, involves a three-neuron pathway. Tropicamide has a strong mydriatic effect. ![]() Postganglionic neurons leave the ciliary ganglion to innervate the iris sphincter. The Edinger-Westphal nucleus gives rise to preganglionic fibers, which then synapse with postganglionic neurons in the ciliary ganglion. The impulses from the pretectal nucleus begin the efferent arm, which projects to the Edinger-Westphal nucleus. This stimulus travels to the optic chiasm, through the optic tract and eventually reaches the pretectal nucleus. 1,3 Pupil constriction starts when light enters the retina and activates the retinal ganglion cells-the beginning of the afferent arm-which then transmit their impulses into the optic nerve. 1,2Ĭontrarily, the parasympathetic pathway is mainly responsible for pupil miosis. The third postganglionic neuron travels to the cavernous sinus and enters the orbit through the short and long ciliary nerves, synapsing to the iris dilator. 1,2 The first neuron begins in the hypothalamus and descends through the midbrain to synapse onto a specific area of the spinal cord, known as the ciliospinal center of Budge. Let’s review their function and clinical role to better understand their present uses and why some of these agents are undergoing re-evaulation for potential new ones. The drops are able to control pupil size by targeting two parts of the autonomic nervous system: the sympathetic and parasympathetic systems. Miotic and mydriatic drops work by acting on these different muscles of the iris. On the other hand, pupil dilation (mydriasis) can either be stimulated by contraction of the iris dilator or by relaxation of the iris sphincter. Pupil constriction (miosis) can either be stimulated by contraction of the iris sphincter or by relaxation of the iris dilator. Treatment uveitis.O p tometrists are well-acquainted with the two opposing muscles in the iris, the sphincter and the dilator, as we witness their effects daily in clinical practice. Pupillary disorders including anisocoria. ![]() Acute anterior uveitis.Īmerican Association for Pediatric Ophthalmology and Strabismus. Pharmacologic dilation of pupil.Īmerican Academy of Ophthalmology. Acute effect of cigarette smoking on pupil size and ocular aberrations: a pre- and postsmoking study. (although older, am allowing this as the best authoritative source)Įrdem U, Gundogan FC, Dinc UA, Yolcu U, Ilhan A, Altun S. Phencyclidine intoxication and adverse effects: a clinical and pharmacological review of an illicit drug. GHB pharmacology and toxicology: acute intoxication, concentrations in blood and urine in forensic cases and treatment of the withdrawal syndrome. Miosis, bradypnea and loss of consciousness with several compacted solid materials in rectum and colon in abdominal X-ray. doi:10.1097/01.7 (using link to full text rather than doi that only goes to paywall summary) Neuro-ophthalmologic side-effects of systemic medications. ![]()
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